| Organization Name: | PENINSULA BIOMEDICAL, INC. |
| NPI Number: | 1376629998 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AMANDA CRISWELL (INSURANCE BILLING MANAGER) |
| Mailing Address: | 15 Camp Evers Ln Scotts Valley |
| State: | CA US |
| Postal Code: | 950664128 |
| Phone Number: | 8314309066 |
| Fax Number: | 8314309068 |
| NPI Enumeration Date: | 10/27/2006 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | 1196930001 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |